ArticleFrontiers in neurology
The non-linear association between preoperative platelet to white blood cell ratio and 30-day postoperative mortality in adult tumor craniotomy: a retrospective cohort study.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: While the platelet to white blood cell ratio (PWR) has been linked to mortality risk in diverse clinical settings, evidence regarding this association in tumor-specific populations, particularly following intracranial tumor resection, is lacking. This study aimed to investigate the association and explore the specific non-linear relationship between preoperative PWR and 30-day postoperative mortality in adult patients undergoing intracranial tumor craniotomy. Methods: This retrospective cohort study conducted a secondary analysis of data from 9,434 patients who underwent craniotomy for intracranial tumors, utilizing the ACS NSQIP database. The exposure variable was preoperative PWR, while the outcome of interest was 30-day postoperative mortality. Cox proportional hazards models were employed to investigate the association between them. To explore non-linear relationships, an additive Cox proportional hazards model incorporating smooth curve fitting was employed, and a two-piecewise Cox regression model was utilized to assess the threshold effect. Results: The study population exhibited a mean preoperative PWR of 27.044 ± 12.564, with a 30-day postoperative mortality rate of 3.148% (297/9434). Multivariable analysis revealed that preoperative PWR was inversely associated with 30-day postoperative mortality (HR = 0.978, 95% CI: 0.967-0.990). Furthermore, a non-linear association between them was observed, with a PWR inflection point at 20.111. Below this value, each unit increase in preoperative PWR was associated with an approximate 8% decrease in the risk of 30-day mortality (HR = 0.920, 95% CI: 0.892-0.949). However, the association was not significant above it (HR = 0.997, 95% CI: 0.984-1.011). Sensitivity analyses confirmed the robustness of our findings. Conclusion: Our study demonstrated an inverse and non-linear association between preoperative PWR and 30-day postoperative mortality in U.S. adults undergoing intracranial tumor craniotomy. These findings warrant confirmation in future studies.
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